COVID-19 Post-Vaccine Questionnaire Thank you for participating in the COVID-19 vaccine study. Please fill out the post-vaccine questionnaire below. COVID-19 Post-Vaccine Study Questionnaire Your Contact Information Full Name: * E-mail address: * Phone number: * Current date: * Vaccination Information Have you already participated or are you scheduled to participate in the COVID-19 vaccine study? (Sterling IRB ID: 8291-BZhang) * Yes No Have you completed all COVID-19 vaccine doses? * Yes No Have you received a COVID-19 booster shot? * Yes No Important! This questionnaire should be completed at least 1 week after receiving the final COVID-19 vaccine dose or at least 5 days after receiving the COVID-19 booster shot. What was the manufacturer of your COVID-19 vaccine? * Pfizer-BioNTechModernaJohnson & Johnson What was the date of your last COVID-19 vaccine dose? * What was the manufacturer of your COVID-19 booster shot? * Pfizer-BioNTechModernaJohnson & Johnson What was the date of your COVID-19 booster shot? * Side Effect Information Even though you were not diagnosed with COVID-19, do you think that you were, at any time, infected with COVID-19? * YesNo Did you experience side effects after receiving the first shot? * YesNo How long did your side effects last after receiving the first shot? No symptoms1 – 3 daysUp to 1 weekLonger than 1 week Tiredness/fatigue * NoneMildModerateSevere Chills * NoneMildModerateSevere Fever * NoneMildModerateSevere Pain Pain at injection site * NoneMildModerateSevere Muscle pain * NoneMildModerateSevere Joint pain * NoneMildModerateSevere Chest pain * NoneMildModerateSevere Stomach pain * NoneMildModerateSevere Rash or Swelling Rash at injection site * NoneMildModerateSevere Swelling at injection site * NoneMildModerateSevere Redness, swelling, or itchiness outside of the injection site * NoneMildModerateSevere Swollen lymph nodes * NoneMildModerateSevere Leg swelling * NoneMildModerateSevere Neurological Headache * NoneMildModerateSevere Blurred vision * NoneMildModerateSevere Gastrointestinal Nausea/Vomiting * NoneMildModerateSevere Diarrhea * NoneMildModerateSevere Shortness of breath * NoneMildModerateSevere Fast-beating, fluttering, or pounding heart * NoneMildModerateSevere Did you experience side effects after receiving the second shot? * YesNoNot applicable. I got the Johnson & Johnson vaccine. How long did your side effects last after receiving the second shot? No symptoms1 – 3 daysUp to 1 weekLonger than 1 week Tiredness/fatigue * NoneMildModerateSevere Chills * NoneMildModerateSevere Fever * NoneMildModerateSevere Pain Pain at injection site * NoneMildModerateSevere Muscle pain * NoneMildModerateSevere Joint pain * NoneMildModerateSevere Chest pain * NoneMildModerateSevere Stomach pain * NoneMildModerateSevere Rash or Swelling Rash at injection site * NoneMildModerateSevere Swelling at injection site * NoneMildModerateSevere Redness, swelling, or itchiness outside of the injection site * NoneMildModerateSevere Swollen lymph nodes * NoneMildModerateSevere Leg swelling * NoneMildModerateSevere Neurological Headache * NoneMildModerateSevere Blurred vision * NoneMildModerateSevere Gastrointestinal Nausea/Vomiting * NoneMildModerateSevere Diarrhea * NoneMildModerateSevere Shortness of breath * NoneMildModerateSevere Fast-beating, fluttering, or pounding heart * NoneMildModerateSevere Compared to the first shot, how were your side effects and symptom severity following the second shot? * SimilarLess severe symptomsMore severe symptoms Did you experience side effects after receiving the booster shot? * YesNo Tiredness/fatigue * NoneMildModerateSevere Chills * NoneMildModerateSevere Fever * NoneMildModerateSevere Pain Pain at injection site * NoneMildModerateSevere Muscle pain * NoneMildModerateSevere Joint pain * NoneMildModerateSevere Chest pain * NoneMildModerateSevere Stomach pain * NoneMildModerateSevere Rash or Swelling Rash at injection site * NoneMildModerateSevere Swelling at injection site * NoneMildModerateSevere Redness, swelling, or itchiness outside of the injection site * NoneMildModerateSevere Swollen lymph nodes * NoneMildModerateSevere Leg swelling * NoneMildModerateSevere Neurological Headache * NoneMildModerateSevere Blurred vision * NoneMildModerateSevere Gastrointestinal Nausea/Vomiting * NoneMildModerateSevere Diarrhea * NoneMildModerateSevere Shortness of breath * NoneMildModerateSevere Fast-beating, fluttering, or pounding heart * NoneMildModerateSevere Compared to the first shot, how were your side effects and symptom severity following the booster shot? * SimilarLess severe symptomsMore severe symptoms Compared to the second shot, how were your side effects and symptom severity following the booster shot? * SimilarLess severe symptomsMore severe symptoms Compared to the second shot, how were your side effects and symptom severity following the booster shot? * SimilarLess severe symptomsMore severe symptoms By clicking the “Submit” button below, I certify that the above answers are true to the best of my knowledge. 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